title: Association of obstructive sleep apnea and glucose metabolism in subjects with or without obesity.
abstract: OBJECTIVE
  The purpose of this study was to investigate whether the impact of obstructive sleep apnea (OSA) on glucose metabolism was different according to the presence or absence of obesity.
  
  
  METHODS
  A total of 1,344 subjects >40 years old from the Korean Genome and Epidemiology Study were included. OSA was detected by home portable sleep monitoring. Plasma glucose, HbA1c, and insulin resistance were compared according to OSA and obesity status. The associations between OSA and impaired fasting glucose (IFG), impaired glucose tolerance (IGT), IFG + IGT, and diabetes were evaluated in subjects with and without obesity after adjusting for several confounding variables. The effect of visceral obesity on this association was evaluated in 820 subjects who underwent abdominal computed tomography scanning.
  
  
  RESULTS
  In subjects without obesity, fasting glucose, 2-h glucose after 75-g glucose loading, and HbA1c were higher in those with OSA than in those without after controlling for age, sex, and BMI. In addition, the presence of OSA in nonobese subjects was associated with a higher prevalence of IFG + IGT and diabetes after adjusting for several confounding variables (odds ratio 3.15 [95% CI 1.44-6.90] and 2.24 [1.43-3.50] for IFG + IGT and diabetes, respectively). Further adjustment for visceral fat area did not modify this association. In contrast, in those with obesity, none of the abnormal glucose tolerance categories were associated with OSA.
  
  
  CONCLUSIONS
  The presence of OSA in nonobese individuals is significantly associated with impaired glucose metabolism, which can be responsible for future risk for diabetes and cardiovascular disease.
authors.affiliation: Corresponding author: Chol Shin, chol-shin@korea.ac.kr.
authors.forename: Nan Hee
authors.initials: NH
authors.lastname: Kim
authors.forename: Nam H
authors.initials: NH
authors.lastname: Cho
authors.forename: Chang-Ho
authors.initials: CH
authors.lastname: Yun
authors.forename: Seung Ku
authors.initials: SK
authors.lastname: Lee
authors.forename: Dae Wui
authors.initials: DW
authors.lastname: Yoon
authors.forename: Hyun Joo
authors.initials: HJ
authors.lastname: Cho
authors.forename: Jae Hee
authors.initials: JH
authors.lastname: Ahn
authors.forename: Ji A
authors.initials: JA
authors.lastname: Seo
authors.forename: Sin Gon
authors.initials: SG
authors.lastname: Kim
authors.forename: Kyung Mook
authors.initials: KM
authors.lastname: Choi
authors.forename: Sei Hyun
authors.initials: SH
authors.lastname: Baik
authors.forename: Dong Seop
authors.initials: DS
authors.lastname: Choi
authors.forename: Chol
authors.initials: C
authors.lastname: Shin
mesh_terms: D000328:Adult; D000368:Aged; D001786:Blood Glucose / Q000378:metabolism*; D002318:Cardiovascular Diseases / Q000097:blood / Q000453:epidemiology* / Q000209:etiology; D003920:Diabetes Mellitus / Q000097:blood / Q000453:epidemiology* / Q000209:etiology; D005260:Female; D005500:Follow-Up Studies; D018149:Glucose Intolerance; D005951:Glucose Tolerance Test; D006801:Humans; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000097:blood* / Q000150:complications; D016017:Odds Ratio; D011236:Prediabetic State / Q000097:blood / Q000453:epidemiology / Q000209:etiology; D015995:Prevalence; D011446:Prospective Studies; D056910:Republic of Korea / Q000453:epidemiology; D018570:Risk Assessment / Q000379:methods*; D020181:Sleep Apnea, Obstructive / Q000097:blood* / Q000150:complications
chemical_list: D001786:Blood Glucose